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New Seeding Therapy Helps Target Breast Tumors with More Accuracy

By HospiMedica staff writers
Posted on 05 Nov 2007
Clinicians are using a new technique in which a small radioactive pellet, or "seed,” is implanted into a mass or suspicious lesion in the breast to pinpoint its precise location for surgical removal.

During the procedure, a radiologist uses a needle to insert a small radioactive seed, approximately the size of a grain of rice, into the mass. More...
Once lodged, surgeons use a wand that detects radioactivity to locate the mass and find the best pathway for removal.

"The new technique is less invasive for the patient and allows us to be more precise when removing possible breast-cancer tumors,” said Dr. Roshni Rao, a surgical oncologist at the University of Texas (UT) Southwestern Medical Center (Dallas; TX, USA), who specializes in breast cancer.

Dr. Rao, an assistant professor of surgery, teamed up with Dr. Michael Ulissey, an associate professor of radiology at UT Southwestern, to use this new procedure. Previously, a radiologist would lance a thin, hooked wire into the breast to help guide the surgeon to the location of the mass. While one end of the wire was lodged at or near the mass, the other end protruded from the patient's skin. Frequently, according to Dr. Rao, the entry site of the wire was distant from the preferred site where a surgeon would prefer to make an incision. The wire also did not always take a direct path to the lesion.

The seed procedure pinpoints the location of a nonpalpable tumor more precisely than the wire and it is more efficient, according to Dr. Rao. The wire method, however, requires patients to undergo the preoperative procedure just hours before surgery because if left in longer, the wire could become dislodged. "With the seed technique, the patient can have the seed inserted up to five days before surgery, any time of day,” Dr. Ulissey said. "The seed procedure also increases efficiency in the radiology department since we are not locked into a two-hour window to insert the wire on the day of the surgery.”

For patient Joan Hollers, aged 58, the preoperative procedure was fast, easy, and painless. After a mammogram had detected a suspicious mass in her left breast, Ms. Hollers consulted with Dr. Rao who decided on the seed procedure. Dr. Ulissey numbed Ms. Hollers' breast before inserting the radioactive seed, which gives off less radiation than the amount emitted by a conventional X-ray. "I felt the prick of what felt to me like a tiny needle,” said Ms. Hollers. "I went home with a small Band-Aid and went to work the next day.” Several days later, she returned to the hospital so that Dr. Rao could remove the suspicious mass.

While the mass in the left breast has been eliminated, Ms. Hollers will undergo chemotherapy for a cancerous tumor that was found in her right breast and cannot be surgically removed until the therapy is complete. Despite the surgery, Ms. Hollers is optimistic. "When I got the news that I didn't have cancer anywhere else in my body I told myself, ‘I'm not dying from this disease,'” said Ms. Hollers.


Related Links:
University of Texas Southwestern Medical Center

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